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索拉非尼可改善早期肾细胞癌的术后效果。

Sorafenib improves the postoperative effect of early stage renal cell carcinoma.

作者信息

Liu Taiyang, Li Jie, Wen Xiuhua, Hui Zhang, Qi Gui

机构信息

Department of Urology, Zhumadian Central Hospital, Zhumadian, Henan 463000, P.R. China.

出版信息

Oncol Lett. 2016 Dec;12(6):4367-4370. doi: 10.3892/ol.2016.5243. Epub 2016 Oct 12.

DOI:10.3892/ol.2016.5243
PMID:28105151
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5228338/
Abstract

Sorafenib was examined to determine whether it improves postoperative effects during early stage renal cell carcinoma (RCC). A total of 133 patients with early renal clear cell carcinoma (T1-2N0M0) with surgical indications were continuously selected. The patients were divided into 3 groups according to different treatments, including the surgery alone group (40 cases), surgery combined with cytokine group (45 cases) and surgery combined with sorafenib group (48 cases), to make a comparison of their clinical effects. The surgery combined with sorafenib group significantly reduced the recurrence rate and increased the survival rate (P<0.05). Its median survival period was >30 months and the other 2 groups were 27 months (P<0.05). In the subsequent 3 months patients were followed up and it was found that the creatinine levels were significantly elevated and hemoglobin levels were significantly decreased. The sorafenib group had significantly lower creatinine levels and higher hemoglobin levels than the other 2 groups (P<0.05). In the 3-month follow-up, vascular endothelial growth factor (VEGF) levels were significantly reduced and tumor necrosis factor (TNF)-α levels were elevated, although the sorafenib group had significantly decreased VEGF levels and a higher TNF-α level than the other 2 groups (P<0.05). The adverse reaction rate was significantly lower than that of the surgery combined with cytokines group (P<0.05). In conclusion, sorafenib improves the early RCC postoperative survival rate and prolongs the survival time while reducing the recurrence rate. It does not increase adverse reactions, and improves renal function, by decreasing the level of VEGF, and improving the level of TNF-α.

摘要

研究索拉非尼是否能改善早期肾细胞癌(RCC)术后效果。连续选取133例有手术指征的早期肾透明细胞癌(T1-2N0M0)患者。根据不同治疗方法将患者分为3组,包括单纯手术组(40例)、手术联合细胞因子组(45例)和手术联合索拉非尼组(48例),比较其临床效果。手术联合索拉非尼组显著降低了复发率并提高了生存率(P<0.05)。其中位生存期>30个月,其他两组为27个月(P<0.05)。在随后的3个月对患者进行随访,发现肌酐水平显著升高,血红蛋白水平显著降低。索拉非尼组的肌酐水平显著低于其他两组,血红蛋白水平高于其他两组(P<0.05)。在3个月的随访中,血管内皮生长因子(VEGF)水平显著降低,肿瘤坏死因子(TNF)-α水平升高,尽管索拉非尼组的VEGF水平显著低于其他两组,TNF-α水平高于其他两组(P<0.05)。不良反应发生率显著低于手术联合细胞因子组(P<0.05)。总之,索拉非尼提高了早期RCC术后生存率,延长了生存时间,同时降低了复发率。它不会增加不良反应,通过降低VEGF水平和提高TNF-α水平改善了肾功能。

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本文引用的文献

1
Surgical Treatment of Renal Cell Carcinoma With Cavoatrial Involvement: A Systematic Review of the Literature.伴有腔静脉心房受累的肾细胞癌的外科治疗:文献系统评价
Ann Thorac Surg. 2016 Mar;101(3):1213-21. doi: 10.1016/j.athoracsur.2015.10.003. Epub 2016 Jan 29.
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Response to Editorial Comment to Features, risk factors and clinical outcome of "very late" recurrences after surgery for localized renal carcinoma: A retrospective evaluation of a cohort with a minimum of 10 years of follow up.对关于局限性肾癌手术后“非常晚期”复发的特征、危险因素及临床结局的社论评论的回应:一项对至少随访10年的队列的回顾性评估
Int J Urol. 2016 Jan;23(1):41. doi: 10.1111/iju.13021. Epub 2015 Nov 30.
3
Changes in Renal Function of Patients with Metastatic Renal Cell Carcinoma During Treatment with Molecular-Targeted Agents.
转移性肾细胞癌患者在接受分子靶向药物治疗期间肾功能的变化。
Target Oncol. 2016 Jun;11(3):329-35. doi: 10.1007/s11523-015-0395-4.
4
Sorafenib treatment for recurrent stage T1 bilateral renal cell carcinoma in patients with Von Hippel- Lindau disease: A case report and literature review.索拉非尼治疗伴有冯·希佩尔-林道病患者的复发性T1期双侧肾细胞癌:病例报告及文献综述
Can Urol Assoc J. 2015 Sep-Oct;9(9-10):E651-3. doi: 10.5489/cuaj.2863. Epub 2015 Sep 9.
5
Initial Experience of Sorafenib Neoadjuvant Therapy Combined with Retroperitoneoscopy in Treating T2 Large Renal Carcinoma.索拉非尼新辅助治疗联合后腹腔镜治疗T2期大肾癌的初步经验
Biomed Res Int. 2015;2015:609549. doi: 10.1155/2015/609549. Epub 2015 Sep 3.
6
Clinical efficacy and prognostic factors of tumor progression in Japanese patients with advanced renal cell carcinoma treated with sorafenib.索拉非尼治疗日本晚期肾细胞癌患者的临床疗效及肿瘤进展的预后因素
Jpn J Clin Oncol. 2015 Mar;45(3):274-80. doi: 10.1093/jjco/hyu200. Epub 2014 Nov 23.
7
Molecular aberrations, targeted therapy, and renal cell carcinoma: current state-of-the-art.分子异常、靶向治疗与肾细胞癌:最新进展。
Cancer Metastasis Rev. 2014 Dec;33(4):1109-24. doi: 10.1007/s10555-014-9533-1.
8
Sorafenib efficacy in thymic carcinomas seems not to require c-KIT or PDGFR-alpha mutations.索拉非尼治疗胸腺癌的疗效似乎并不需要 c-KIT 或 PDGFR-α 突变。
Anticancer Res. 2014 Sep;34(9):5105-10.
9
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Urol Oncol. 2013 Nov;31(8):1800-5. doi: 10.1016/j.urolonc.2012.04.019. Epub 2012 May 31.
10
The combination of IL-21 and IFN-alpha boosts STAT3 activation, cytotoxicity and experimental tumor therapy.白细胞介素-21与α干扰素联合使用可增强信号转导和转录激活因子3(STAT3)的激活、细胞毒性及实验性肿瘤治疗效果。
Mol Immunol. 2009 Feb;46(5):812-20. doi: 10.1016/j.molimm.2008.09.006. Epub 2008 Oct 22.